Introduction

Kostha is derived from the word “Kush Dahe” Dhatu, means in which digestion occurs is identified as Kostha (Lal, n d). Kostha is also one of the pathway of diseases and is known as internal pathway of diseases (Sharma, 2014). Although the concept of Kostha is described in many places, clinically it is classified into three type’s .i.e. Mridu (soft bowel), Madhyama (normal bowel) and Krura (hard bowel) in the context of Samshodhana (purification therapy) as Snehana (oleation), Virechana etc.

According to some Acharya, Kostha is of four types e.g. Mridu, Madhyama, Sama and Krura (Sharma, 2014). Clinically the term Kostha is expressed in the context of bowel habit and it mostly depends on individual’s Prakriti (constitution of body). That’s why for the assessment of Kostha bowel habit should be examined considering frequency, consistency, straining during defecation, required more time for proper defecation, feeling of lightness, satisfaction etc. prior encounters of diarrhoea and constipation and earlier experiences of purgatives and laxatives (Sharma, 2014).

Need of questionnaire

During the study, the problem in assessment of Kostha, is usually encountered. Due to lack of appropriate questionnaires for the assessment of Kostha, it is very difficult to identify various types. Hence the questionnaires were designed to assess the Kostha. There aren’t validated and standard questionnaire of Kostha available. Kostha is assessed based on gastrointestinal system motility and bowel habit. It is important to understand because it helps to plan the appropriate therapeutics based on Kostha variety and it also helps the individuals to adopt lifestyle according to nature of Kostha (Sharma, 2014; Sharma, 2014).

Design of questionnaire

The questionnaire was developed after studying the characters of Kostha present in Ayurvedic Samhita (Sharma, 2014; Sharma, 2014), published articles (Vasant, Patil, & Baghel, 2008) and other text books. Further to this study, each character of Kostha questionnaire was validated. The questionnaire was designed in such a way that each trait was converted into simple form keeping the original idea intact. Each question/trait was allocated equal marks for Kostha assessment. Total 9 questions were designed in Kostha assessment questionnaire. One has to simply read the question and has to assess the trait in him/her and has to allocate the marks likewise at the end, one can calculate the scores for different types of Kostha (Atridev, 2009; Sharma, 2014).

Process of Validation of the questionnaire

New questionnaires were designed by Byadgi, Saini et al , therefore its validation is necessary.

Determining Validity Experimentally

The validity of a test is determined experimentally by finding the correlation between the test and some independent criteria. A criterion may be an objective measure of performance, or a qualitative measure such as a judgement of the character or excellence of work done (Anastasi, 1982). A trade test may be validated against time taken to carry out standard operations, amount done in a given time or excellence of work. A high correlation between a test and a criterion is, evidence of validity provided (1) the criterion was set up independently and (2) both the test and criterion are reliable. The index of reliability is sometimes taken as measure of validity (Bland & Altman, 1997). The correlation coefficient, it will be recalled, gives the relationship between obtained scores and their theoretical true counterparts. If the reliability coefficient of a test is 0.81, for example $r_{1\infty } is \sqrt{0.81}$ or 0.90. This means that the test measures true ability to the extent expressed by an r of 0.90 (David, 2015; Porath, Slutske, & Butcher, 1989).

Test for Reliability/Consistency

The data was fed on to the computer using the software ‘Statistical Package for Social Sciences (SPSS)’ (Version 16.0). For the conversion of responses into numerical format, positive response for Krura Kostha feature was incorporated as “0” for all 9 questions, for Madhyama Kostha feature was incorporated as “1” and for Mridu Kostha feature was incorporated as “2” for 7 questions. In question no. 3 and 6 positive responses for either Madhyama Kostha or Mridu Kostha feature was incorporated as “1”. Kostha was assessed as Krura, Mridu and Madhyama. Kostha was assessed as having at least 5 or more than 5 traits of a particular type of Kostha.

Reliability test in form of Cronbach’s coefficient Alpha was carried out after Item Analysis and Correlation. This was done to find out the correlation between the respective item and total sum score and the internal consistency of the scale if the respective item would be deleted.

Cronbach’s Alpha= $\frac{N{.}_{\overline{c}}}{\overline{v}+(N-1).\overline{c}}$

N= Number of items

$\overline{c}$ = Average inter item covariance among items

$\overline{v}$ = Average variance

For the validation of scale, value of alpha greater than 0.7 was considered acceptable.

The Pilot Study

An initial administration of the scale (Table 1) utilized 60 volunteer subjects ranging from age 16 and above. Ninety percent of the scores were indicative of satisfaction. Majority of scores being high and indicative satisfaction. Item analysis of data obtained in this pilot study administration indicated that one item was to be discarded.

The Final Study

After a scale is developed and its reliability and validity are established, its research practicality must also be demonstrated. One indication of its proper development should be that it will function appropriately when used as intended. So finally 9 items were administered to a group of 60 volunteer living in of Varanasi. Result of this study indicated that, in general, items correlated well with the total scale, that there was a very high level of internal consistency.

As the above Table 2 of Kostha shows the value of “Alpha if item deleted” is not much altering resultant Cronbach’s Alpha of Kostha (.835). Cronbach’s Alpha of near to 0.8, that shows its good consistency/reliability.

Conclusions

Relaible and valid scales were needed to assess the kostha. Hence questionnaire was developed in the form of scale for the purpose of assessing Kostha. It was administered to a total of 60 subjects. The scale was proved to be of sufficient reliability and of high internal consistency.